Presidential address / by Sir Joseph Fayrer.

  • Fayrer, Sir Joseph, 1824-1907.
Date:
[1891]
Catalogue details

Licence: Public Domain Mark

Credit: Presidential address / by Sir Joseph Fayrer. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    causes which induce disease and shorten life are greatly under our own control, and that we have it in our power to restrain and diminish them, and to remove that which has been called “ the self-imposed curse of dying before the prime of life.” It is indeed only recently that the resources of medical science have been specially devoted to the prevention as distinguished from the cure of disease, and how far successfully, I hope in a few words to show, whilst I trust the proceedings of the various sections of this Congress will indicate how much remains to be done. Did time permit, I might illustrate the progress of Preventive Medicine by contrasting the state of England with its population of more than 29,000,000 during the Victorian, with the England of the Elizabethan age with its 4,000,000. I might remind you of the frightful epidemics which had devastated the land in the forms of black death, sweating sickness, plague, petechial typhus, eruptive fevers, small-pox, influenza, and other diseases, such as leprosy, scurvy, malarial fever, dysentery, &c., of the wretched mode of living, bad and insufficient food, filthy dwellings, and ill-built towns and villages, with a country uncultivated and covered with marshes and stagnant water ;—[according to Defoe one-fifteenth part of England consisted of standing lakes, stagnant water and moist places, the land unreclaimed, and with the chill damp of marsh fever pervading all]. The homes of the people were wooden or mud houses, small and dirty, without drainage or, ventilation, the floors of earth covered with straw or rushes, which remained saturated with filth and emitting noxious miasmata. The streets were narrow and unpaved, with no drains but stagnant gutters and open cesspools, while the food was principally salted meat with little or no vegetable. To this may be added a large amount of intemperance and debauchery. As it is, I can only just allude to them. In such conditions disease found a congenial nidus, and by a process of evolution assumed the various epidemic forms which proved so destructive to life. Some of these have gone, let us hope never to return, and the conditions which fostered, if they did not cause them, have gone also. Can we venture to hope that it will be the same with those that remain; our immunity during the last diffusion of cholera gives some ground for thinking it may be so, if, indeed, the legislature and popular intelligence should be of accord on the subject. If we turn to the present, we find that great improvements have gradually been made in the mode of living ; the houses are better constructed, the drainage and ventilation are more complete, the land is better cultivated, and the subsoil better drained; marsh fever and dysentery, at one period so rife, arc unknown, and leprosy has long since disappeared. The death-rate is considerably reduced, and the expectancy of life enhanced. Water is purer, food is more varied and nutritious, clothing is better adapted to the climate, the noxious character of many occupations has been mitigated, and the mental, moral, and physical aspects of the people altogether improved; education is general, a better form of government prevails, and the social conditions are far in advance of what they have been; but still the state of A 2 our